Voice disorders related to teaching: a case-control study / Distúrbio de voz relacionado ao trabalho docente: um estudo caso-controle

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Introduction Teachers constitute a professional category with high occurrence of voice disorders due to this occupations intense vocal demand and to unfavorable work environments. The presence of voice disorder may jeopardize their careers because these professionals depend essentially on their voices to work. Aim To identify the association between voice disorders and job stress and voice disorders and work ability among teachers from public schools of São Paulo. Methods This is a pair matched case-control study. The case group was composed of teachers with vocal disorder complaints, with vocal quality deviations in the speech pathology evaluation and vocal fold lesion or altered according an otorhinolaryngologist evaluation. The control group was randomly selected at the same schools as the case group individuals worked. Both groups answered the following questionnaires: Conditions of Vocal Production Teacher (CVP-T), Vocal Handicap Index (VHI), Job Stress Scale (JSS) and Work Ability Index (WAI). The analysis was performed using qui-square association test, univariate and multiple regression models. Results The analyses of the case and control groups showed comparable samples, with no significant differences of demographic and control variables. The groups differed, as expected, on vocal symptoms. Comparison in the Voice Handicap Index confirmed this difference, with the highest scores for the case group. Regarding the association of job stress, 78,8 per cent of control group are concentrated in lower levels of demand, while 69,3 per cent of case group are at higher levels (p=0,019). Regarding the work control, the situation is reversed, 63,1 per cent of the subjects in the control group manifested higher levels of control, while 73,1 per cent of case group are in the lower categories (p=0,034). Analyzing the association of work ability index, there is an association between low work ability and voice disorder (p<0,001). This association is remains in multivariate analysis, where low (OR=9,5, p=0,001) and moderate (OR=6,7, p <0,001) work ability 11 were also associated with voice disorder. Analyzing the job stress scale with age and acoustics, there is an association between voice disorder and high mental strain, characterized by psychological demands and low decision latitude at work (OR=2,2, p=0,020), age 50-65 years (OR=2,9, p=0,012) and poor acoustics in school (OR=2,6, p=0,003). In the analysis of these categories with the ability to work, it is observed that low (OR=12,2, p<0,001) and moderate (OR=7,7, p<0,001) work ability, age 50-65 years (OR=3,7, p=0,006) and poor acoustics (OR=2,7, p=0,007) are factors associated with voice disorder. Conclusions There is a statistical association between the presence of voice disorders and high mental strain, independently of age and poor acoustics in school. Low and moderate work ability showed a correlation with voice disorder independently of stress at work, age and poor acoustics. The age group 50-65 years and poor acoustics were associated with voice disorder independently of job stress and work ability (OR=2,7, p=0,007) are factors associated with voice disorder

ASSUNTO(S)

docentes occupational health teachers epidemiologia voice disorders saúde ocupacional distúrbios da voz epidemiology

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